Gastric Cancer Treatments in Asia: Surgery, Chemotherapy, and Targeted Therapy

Gastric cancer (stomach cancer) is one of the most prevalent cancers in Asia, particularly in East Asia, where it remains a leading cause of cancer-related deaths. While surgery, chemotherapy, and radiation form the backbone of treatment, targeted therapy and immunotherapy are transforming outcomes. This article explores gastric cancer treatments in Asia, highlighting surgical options, chemotherapy, targeted drugs, regional disparities, and future directions.

Gastric Cancer in Asia: Epidemiology

• Global burden: Gastric cancer ranks among the top five cancers worldwide.
• Asia’s hot spot: Japan, South Korea, and China account for over 60% of global cases. Mongolia has one of the world’s highest gastric cancer mortality rates. India and Southeast Asia report rising cases linked to diet and Helicobacter pylori infection.
• Risk factors: High salt intake and processed foods. Chronic Helicobacter pylori infection. Smoking and alcohol use. Genetic predisposition.

Surgery: Cornerstone of Curative Treatment

Types of Surgery

• Subtotal Gastrectomy: Removal of part of the stomach for localized tumors.
• Total Gastrectomy: Removal of the entire stomach for widespread disease.
• Lymph Node Dissection (D2 resection): Standard in Japan and South Korea, improving survival.

Regional Expertise

• Japan & South Korea: Leaders in minimally invasive laparoscopic and robotic gastrectomy.
• China: Rapidly increasing use of advanced surgical techniques.
• India & Southeast Asia: Limited availability outside urban hospitals.

Chemotherapy

Neoadjuvant Chemotherapy

• Administered before surgery to shrink tumors.
• Regimens: FLOT (5-FU, leucovorin, oxaliplatin, docetaxel) gaining popularity.

Adjuvant Chemotherapy

• Administered after surgery to reduce recurrence risk.
• S-1 (oral fluoropyrimidine) widely used in Japan and South Korea.
• CAPOX regimen (capecitabine + oxaliplatin) used across Asia.

Palliative Chemotherapy

• For advanced or metastatic disease, extends survival.

Targeted Therapy

HER2-Positive Gastric Cancer

• Trastuzumab (Herceptin): Standard for HER2-positive advanced gastric cancer.
• Widely available in Japan, South Korea, and China; expanding in India.

VEGF Pathway Inhibitors

• Ramucirumab: Used in second-line therapy for advanced cases.

Emerging Targets

• Claudin18.2-targeted therapies: In clinical trials in China and Japan.
• MET inhibitors being tested in Asian populations.

Immunotherapy

PD-1/PD-L1 Inhibitors

• Nivolumab and pembrolizumab: Showing strong results in advanced gastric cancer.
• Approved in Japan, South Korea, and China; expanding in clinical trials across Asia.

Combination Therapies

• Ongoing studies combining immunotherapy with chemotherapy and targeted therapy.

Regional Insights

• Japan: Pioneering gastric cancer screening programs with high early detection rates.
• South Korea: Leading outcomes due to early screening and advanced surgery.
• China: Largest number of gastric cancer cases; rapid adoption of immunotherapy and targeted drugs.
• India: Rising cases, but late diagnosis common; limited access to advanced therapies.
• Southeast Asia: Limited screening programs; many patients present at advanced stages.

Challenges in Asia

1. Late Diagnosis: Many patients in developing regions diagnosed at stage III or IV.
2. Healthcare Inequality: Advanced treatments concentrated in major cities.
3. Cost of Targeted Therapy: HER2 and immunotherapy drugs remain unaffordable for many.
4. Lifestyle Risk Factors: High salt diets and low awareness continue to drive incidence.

Future of Gastric Cancer Care in Asia

1. Expansion of population-based screening in high-risk countries.
2. Personalized medicine: Genetic profiling for individualized treatments.
3. Broader immunotherapy access through local production and generics.
4. AI-assisted endoscopy for early detection of precancerous lesions.
5. Public health policies targeting diet and Helicobacter pylori eradication.

Conclusion

Gastric cancer remains a serious health challenge in Asia, but advances in surgery, chemotherapy, targeted therapy, and immunotherapy are improving survival rates.

The future of gastric cancer treatment in Asia depends on early detection, equitable access to advanced therapies, and integration of precision medicine—helping millions of patients achieve better outcomes.

Written by:MedCure Asia Editorial Team
The MedCure Asia Editorial Team specializes in delivering accurate, well-researched health insights across Asia. Our mission is to provide readers with trusted guidance on medical conditions, treatments, and wellness practices.